CDC Health Disparities and Inequalities Report – United States – 2011 (And Link About Recent WHO Report on Inequities and Avoidable Deaths)

In my humble opinion, a strong argument for affordable, accessible health care for all regardless of one’s income or where one lives. Health disparities   are not found only within groups of people who have the ability to pay for treatments or who are able to get needed treatment quickly.

While this train of thought may be labeled as creeping socialism, health care cost/access challenges are  a matter of justice and fairness for all.  Is there agreement on what is just or what is fair? Well, no. However, I believe we all can put differences aside in working for what is best for all.

 

From the Centers for Disease Control and Prevention (CDC) January 13th news release

Americans’ differences in income, race/ethnicity, gender and other social attributes make a difference in how likely they are to be healthy, sick, or die prematurely, according to a report by the Centers for Disease Control and Prevention.

For instance, state-level estimates in 2007 indicate that low income residents report five to 11 fewer healthy days per month than do high income residents, the report says. It also says men are nearly four times more likely than women to commit suicide, that adolescent birth rates for Hispanics and non-Hispanic blacks are three and 2.5 times respectively those of whites, and that the prevalence of binge drinking is higher in people with higher incomes.

The data are in the new “CDC Health Disparities and Inequalities Report — United States, 2011”. The report also underscores the need for more consistent, nationally representative data on disability status and sexual orientation.

“Better information about the health status of different groups is essential to improve health. This first of its kind analysis and reporting of recent trends is designed to spur action and accountability at the federal, tribal, state and local levels to achieve health equity in this country,” said CDC Director Thomas R. Frieden, M.D., M.P.H.

The report, the first of a series of consolidated assessments, highlights health disparities by sex, race and ethnicity, income, education, disability status and other social characteristics. Substantial progress in improving health for most U.S. residents has been made in recent years, yet persistent disparities continue.

Released as a supplement to CDC’s Morbidity and Mortality Weekly Report, the report addresses disparities at the national level in health care access, exposure to environmental hazards, mortality, morbidity, behavioral risk factors, disability status and social determinants of health – the conditions in which people are born, grow, live and work.

Findings from the report’s 22 essays include:

In 2007, non-Hispanic white men (21.5 per 100,000 population) were two to three times more likely to die in motor vehicle crashes than were non-Hispanic white women (8.8 per 100,000). The gender difference was similar in other race/ethnic groups.

In 2007, men (18.4 per 100,000) of all ages and races/ethnicities were approximately four times more likely to die by suicide than females (4.8 per 100,000).

In 2007, rates of drug-induced deaths were highest among non-Hispanic whites (15.1 per 100,000) and lowest among Asian/Pacific Islanders (2.0 per 100,000).

Hypertension is by far most prevalent among non-Hispanic blacks (42 percent vs. 29 percent among whites), while levels of control are lowest for Mexican-Americans (31.8 percent versus 46.5 percent among non-Hispanic whites).

Rates of preventable hospitalizations increase as incomes decrease. Data from the Agency for Healthcare Research and Quality indicate that eliminating these disparities would prevent approximately 1 million hospitalizations and save $6.7 billion in health care costs each year.

Rates of adolescent pregnancy and childbirth have been falling or holding steady for all racial/ethnic minorities in all age groups. However, in 2008, disparities persist as birth rates for Hispanic adolescents (77.4 per 1,000 females) and non-Hispanic black adolescents (62.9 per 1,000 females) were three and 2.5 times those of whites (26.7 per 1,000 females), respectively.

In 2009, the prevalence of binge drinking was higher in groups with incomes of $50,000 or above (18.5 percent) compared to those with incomes of $15,000 or less (12.1 percent); and in college graduates (17.4 percent), compared to those with less than high school education (12.5 percent). However, people who binge drink and have less than $15,000 income binge drink more frequently (4.9 versus 3.6 episodes) and, when they do binge drink, drink more heavily (7.1 versus 6.5 drinks).

The report supports the Healthy People 2020 goals and the forthcoming National Partnership for Action (NPA) to End Health Disparities. The report also complements the upcoming AHRQ National Healthcare Disparities Report *** and underscores the need to connect those working in clinical care and public health, especially at the local level.

“CDC publishes this report today not only to address gaps in health between populations in our country but also to begin to measure progress in years to come in reducing these gaps and inequities going forward,” said Leandris Liburd, Ph.D., M.P.H., M.A., recently appointed director of CDC’s Office of Minority Health and Health Equity. Dr. Liburd will provide leadership for the office and CDC’s public health programs, policies, surveillance and research efforts in achieving health equity.

The full “CDC Health Disparities and Inequalities Report — United States, 2011”, is available at http://www.cdc.gov/mmwr.

*** AHRQ National Healthcare Disparities Report Fact Sheet
AHRQ- Measure Healthcare Quality, including section on National Healthcare Disparities Reports (2003-09) with related documents

Related articles

• Inequities and Avoidable Deaths (thirdworlddd.wordpress.com)
  Excerpts
  • When there are disparities, especially in health, there result avoidable deaths. The WHO estimates that better use of existing preventive measures could reduce the global burden of disease by as much as 70% (WHO, 3). That means that we already have much of the needed solutions, but why are we not implementing them? For example, Diarrheal Disease is a preventable, avoidable disease; with basic sanitation and access to clean water, a huge difference could be made in eradicating the affliction. Why are these things not being put into place?
  • What we can take from this is that we need to change the way we look at the disparities, by getting our hands dirty. We need to get into these places and ask questions, not answer them ourselves. The extent of human suffering is vast, but it needs to be witnessed in order to gain solutions. If these people can bare to live their lives full of inequities, inequalities, and misfortune, we can bare to listen to what they have to say.
• Disability as a Disparity (couragecenter.wordpress.com)

New superbug genes sure to spread, U.S. expert says

New superbug genes sure to spread, U.S. expert says

From a December 15 Reuters Health News item by Maggie Fox

WASHINGTON (Reuters) – A little loop of genes that give bacteria the power to resist virtually all known antibiotics is spreading quickly and likely to cause doctors headaches for years to come, an expert predicted on Wednesday.

They come on the equivalent of a genetic memory stick — a string of genes called a transmissible genetic element. Bacteria, unlike higher forms of life, can swap these gene strings with other species and often do so with wild abandon.

This one is called New Delhi metallobeta-lactamase 1 or NDM-1 for short and Dr. Robert Moellering of Harvard Medical School and Beth Israel Deaconess Medical Center in Boston predicts it will cause more trouble in the coming years.

“What makes this enzyme so frightening is not only its intrinsic ability to destroy most known beta-lactam antibiotics but also the company it keeps,’ Moellering wrote in a commentary in the New England Journal of Medicine.….

….

Antibiotic-resistant bacteria are nothing new — virtually all strains of the common Staphylococcus bacteria are now resistant to penicillin. Almost as soon as penicillin was introduced in the 1940s, bacteria began to develop resistance to its effects, prompting researchers to develop many new generations of antibiotics.

But their overuse and misuse have helped fuel the rise of drug-resistant “superbugs.” The U.S. Centers for Disease Control and Prevention says most infections that people get while in the hospital resist at least one antibiotic.

[Click here for the CDC Web page on Antibiotic Resistance
It contains detailed information under topics as About Antimicrobial Resistance and Diseases/Pathogens Associated with Antimicrobial Resistance.
References and Resources includes information on campaigns and surveillance systems as well as links to related podcasts, e-cards, and videos.  There are also links to government and organizational Web sites.

KILLER MRSA

For example, half of all Staphylococcus aureus infections in the United States are resistant to penicillin, methicillin, tetracycline and erythromycin. Methicillin-resistant staph aureus or MRSA killed an estimated 19,000 people in the United States alone in 2005.

NDM-1 resists many different types of antibiotic. In at least one case, the only drug that affected it was colistin, a toxic older antibiotic.

“Thus far, the majority of isolates in countries throughout the world can be traced to subjects who have traveled to India to visit family or have received medical care there,” Moellering wrote.

“However, the ability of this genetic element to spread rapidly among Enterobacteriaceae means that there will almost certainly be numerous secondary cases throughout the world that are unrelated to travel to the Indian subcontinent.”

Experts have been warning for years that poor hospital practices and the overuse of antibiotics spread dangerous bacteria, but practices are changing only slowly.

“The fact that there is widespread nonprescription use of antibiotics in India, a country in which some areas have less than ideal sanitation and a high prevalence of diarrheal disease and crowding, sets the ideal stage for the development of such resistance,” Moellering wrote….